Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain
Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain
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DOI：
10.1016/j.cmi.2020.09.042
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发表时间：
2021-08-05
影响因子：
14.2
通讯作者：
Guinea, Jesus
中科院分区：
文献类型：
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作者：
Escribano, Pilar;Rodriguez-Sanchez, Belen;Guinea, Jesus
目的：我们的目的是评估西班牙烟曲霉对唑类药物耐药的百分比。广义烟曲霉临床分离株-无论其临床意义-从2019年2月15日至5月14日。根据EUCAST 9.3.2方法学，对显示唑类耐药的分离株进行分子鉴定，并在A.结果：从29家医院（A.严格意义上的烟曲霉（n = 828）和隐种（n = 19）。下呼吸道感染占94.0%（797/847）。只有隐蔽种属对阿朴霉素B耐药。847株分离株中有63株（7.4%）对≥ 1种唑类耐药。隐蔽种对唑类药物的抗性高于A.严格意义上的烟曲霉（95%，18/19 vs. 5.5%，45/828）;艾沙康唑与最低数量的非野生型分离株相关。抗性的主要机制是TR34-L98H置换的存在（63个中的n = 24个）。在725例患者中，48例（6.6%）携带隐种（n = 14）或A。严格意义上的烟曲霉（n = 34; 4.7%）耐药菌株。在24个研究城市中的7个医院的患者中检测到携带TR34-L98H（n = 19）或TR46/Y121F/T289A（n = 1）突变的严格意义上的烟曲霉。fumigatus sensu lato在西班牙分离。TR34-L98H是cyp51A基因的显性替换，尽管它的存在并不普遍。(C)2020年欧洲临床微生物学和传染病学会。由爱思唯尔有限公司发布。保留所有权利。
Objectives: We aimed to assess the percentage of azole resistance in Aspergillus fumigatus in Spain.Methods: Thirty participating Spanish hospitals stored all morphologically identified A. fumigatus sensu lato clinical isolates-regardless their clinical significance-from 15 February to 14 May 2019. Isolates showing azole resistance according to the EUCAST 9.3.2 methodology were molecularly identified and the cyp51A gene was studied in A. fumigatus sensu stricto isolates.Results: Eight hundred and forty-seven isolates from 725 patients were collected in 29 hospitals (A. fumigatus sensu stricto (n = 828) and cryptic species (n = 19)). Isolates were mostly from the lower respiratory tract (94.0%; 797/847). Only cryptic species were amphotericin B resistant. Sixty-three (7.4%) out of the 847 isolates were resistant to >= 1 azole(s). Azole resistance was higher in cryptic species than in A. fumigatus sensu stricto (95%, 18/19 vs. 5.5%, 45/828); isavuconazole was associated to the lowest number of non-wild type isolates. The dominant mechanism of resistance was the presence of TR34 -L98H substitutions (n = 24 out of 63). Out of the 725 patients, 48 (6.6%) carried either cryptic species (n = 14) or A. fumigatus sensu stricto (n = 34; 4.7%) resistant isolates. Aspergillus fumigatus sensu stricto harbouring either the TR34 -L98H (n = 19) or TR46 /Y121F/T289A (n = 1) mutations were detected in patients in hospitals located at 7/24 studied cities.Discussion: Of the patients, 6.6% carry azole-resistant A. fumigatus sensu lato isolates in Spain. TR34-L98H is the dominant cyp51A gene substitutions, although its presence is not widespread. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.